History of Hospitals Essays

History of Hospitals Essays History of Hospitals Essay History of Hospitals Essay Hospitals originated in the 17th century primarily as an institution to provide housing and basic healthcare for the poor. It provided a haven to quarantine individuals to prevent the spread of highly contagious diseases. The technologies and vaccinations available did not allow for the comprehensive care we rely on today. Those who could afford clinical care would pay doctors and nurses to provide services in their home. In the early 19th century, as industrial cities became more populated, the demand for clinical and institutional care grew. Medical technology and scientific innovation made ambulatory healthcare available, yet there was not enough capital to support building large institutions viable to facilitate it. Religious organizations, philanthropists, and local governments built private and public institutions designed to deliver ambulatory, inpatient, and emergency care to local populations. By the beginning of the 20th century, hospitals became capable for research, development, and scientific discovery. Facilities became very large, housing and treating patients as well as facilitating medical research. Modern hospitals now provide clinical care to the most complex and critically ill patients while researching, innovating, and advancing medical technology. With increasing demand for treatment of chronic care, as well as the advancements in acute ambulatory care, modern hospitals have integrated vertically and horizontally to diversify their brand and provide an umbrella of accountability as an Integrated Delivery System. After World War II, managed care entered the marketplace. Insurance companies began to contract with hospital groups and Integrated Delivery Systems to provide comprehensive insurance and healthcare delivery, all centered around a hospital or group of hospitals. Hospitals have become a catalyst to the industry, providing the most intensive and critical care to the people who need it most. These institutions have provided a refuge for the sickest and poorest individuals in the community who would be left without care otherwise. Integrated Delivery Systems have been established, promoting corporate investment by mitigating risk, easing the burden on non-profit public hospitals funded by government entities and religious organizations. Vertical integration provides a wide range of delivery rather than one specialty, assuming greater risk leading to innovative relationships with patients and payers. Horizontal integration streamlines processes, provides greater economies of scale, and provides a solid foundation for larger delivery systems. Hospitals have been invaluable to the industry since the 17th century. However, the cost of hospital care has grown dramatically in the past 50 years, and the sources of revenue have shifted from private funding and health insurance to federal programs such as Medicare and Medicaid. Medicare accounts for nearly a third of all hospital expenditures, whose fee schedules and DRG payment model do not promote quality, preventative care. The decrease in the number of large hospitals over the past few decades has yielded to a growth in smaller, for-profit specialty hospitals which places a greater burden on community hospitals that provide costly emergency and complex care. The Hill-Burton Act of 1946 provided federal funding for hospitals in middle and lower class areas with caveats and regulations for how care was delivered. Hospitals that received funding were required to provide uncompensated care to those who could not afford it, placing a large burden of risk to the facility. The Public Service Health Act reinforced these regulations by broadening the scope of â€Å"inability to pay†, leading to an increase in lawsuits and administrative costs to the already large hospital budgets. Lean management with implementation in information technology are key to hospitals’ future success as a cornerstone to integrated delivery systems. In order for hospitals to be effective as we progress into the 21st century, a building structure should facilitate individual doctors in performing their various activities. But at the same time, it must not complicate the indispensable cooperation and communication between specialists and multidisciplinary diagnosis and treatment of patients. Structure must contribute to efficiency and transparency of processes involving different patient categories, but without fragmenting the work processes of doctors too much and decentralizing technology to an unmanageable scale (Geisler et al 158). References Geisler, Eliezer, Koos Krabbendam, and Roel Schuring. Technology, Health Care, and Management in the Hospital of the Future. Greenwood Publishing Group, 2003. 158. eBook. Williams, Stephen J. Introduction to Health Services. 7th ed. Clifton Park, NY: Thomson Delmar Learning, 2008. 183-97. Print.

Definition and Examples of Dissoi Logoi in Rhetoric

Definition and Examples of Dissoi Logoi in Rhetoric In classical rhetoric, dissoi logoi is the concept of opposing arguments, a cornerstone of Sophistic ideology and method. Also known as  antilogike. In ancient Greece, the dissoi logoi were rhetorical exercises intended for imitation by students. In our own time, we see dissoi logoi at work in the courtroom, where litigation is not about truth but rather the preponderance of evidence (James Dale Williams, An Introduction to Classical Rhetoric, 2009). The words dissoi logoi are from the Greek for double arguments.  Dissoi Logoi  is the title of an anonymous  sophistic  treatise thats generally thought to have been written about 400 BC. See Examples and Observations below. Also see: ArgumentationDebateDialecticElenchusMemoryPreparing an Argument: Explore Both Sides of an IssueSocratic DialogueSophism and SophistryStasis Examples and Observations The essential feature [of dissoi logoi], [G.B.] Kerferd writes, was not simply the occurrence of opposing arguments but the fact that both opposing arguments could be expressed by a single speaker, as it were within a single complex argument (The Sophistic Movement [1981], p. 84). Such an argumentative procedure could force any question into an Aporia by pointing out that each side was true within the terms that it had chosen to develop the argument. Both sides depended, ultimately, on language and its imperfect correspondence to the outside world, whatever one might think that world to be. A form of this analytical technique has recently been revived under the name of Deconstruction. Or, the parties could agree to accept one position as superior, even though it manifestly depended on human argument and not Divine Truth. It is from this accommodation to antithetical structure that Anglo-Saxon jurisprudence descends: we arrange social issues into diametrically opposed questions, arran ge a dramatic display of their conflict, and (since the law cannot afford aporia as a conclusion to social disputes) accept the jury-audiences verdict as a defining truth, a precedent for future disputation.(Richard Lanham, A Handlist of Rhetorical Terms, 2nd ed. University of California Press, 1991) In essence, dissoi logoi posits that one side (logos) of an argument defines the existence of the other, creating a rhetorical situation in which at least two logoi struggle for dominance. In contrast, Western cultures implicit assumption that argument is about truth or falsity urges one to assume that one side of the argument is true or more accurate and that other accounts are false or less accurate. Quite differently, Sophists acknowledge that one side of the argument might in a particular context represent the stronger logos and others the weaker, but this does not preclude a weaker logos from becoming the stronger in a different or future context. Sophism assumes that the stronger logos, no matter how strong, will never completely overcome competing logoi and earn the title of absolute truth. Ratherand this is the heart of dissoi logoiat least one other perspective is always available to serve as an other to the stronger argument.(Richard D. Johnson-Sheehan, Sophistic Rhetoric. Theorizing Composition: A Critical Sourcebook of Theory And Scholarship in Contemporary Composition Studies, ed. by Mary Lynch Kennedy. Greenwood, 1998) Dissoi LogoiThe Original Treatise Dissoi Logoi (twofold arguments) is the name, taken from its first two words, that has been given to a tract which is attached to the end of the manuscript of Sextus Empiricus. . . . It contains arguments which are capable of bearing opposed meanings, and it has sections dealing with Good and Bad, Decent and Disgraceful, Just and Unjust, True and False, together with a number of untitled sections. It has the look of a students lecture notes, but this appearance may be deceptive. The contents are what we might expect in Protagoras Antilogiai, but it is safer simply to designate them as sophistic.For example, to prove that Decent and Disgraceful are really the same, the following double argument is brought forward: for women to wash themselves in the home is decent, but women washing in the palaestra would be disgraceful [it would be all right for men]. Therefore, the same thing is both disgraceful and decent.(H. D. Rankin, Sophists, Socratics and Cynics. Barnes Noble Books, 1983) Dissoi Logoi  on Memory The greatest and fairest discovery has been found to be memory; it is useful for everything, for wisdom as well as for the conduct of life. This is the first step: if you focus your attention, your mind, making progress by this means, will perceive more. The second step is to practice whatever you hear. If you hear the same things many times and repeat them, what you have learned presents itself to your memory as a connected whole. The third step is: whenever you hear something, connect it with what you know already. For instance, suppose you need to remember the name Chrysippos, you must connect it with chrusos (gold) and hippos (horse).(Dissoi Logoi, trans. by Rosamund Kent Sprague. Mind, April 1968)